Renal patients miss cheese. Bottom line. I work with dialysis patients every day and we talk about cheese A LOT. It is often limited on the renal diet due to the high amount of phosphorus and in some cases sodium content as well.

Cheese or no cheese?

What most patients don’t know is that cheese can be incorporated into the renal diet. The key is doing your research. With tools like the DaVita Diet Helper on DaVita’s website, nutrient analyzers online, or the USDA’s nutrient database, it can make finding information about cheese much easier than checking the labels of over hundreds of different varieties you will find in your local grocery store. These tools can help narrow it down to a small list you want to grab on your next shopping trip. Keep reading to find out what you should keep in mind when searching for your next bite of cheese.

Phosphorus

You will typically not see phosphorus on the cheese label, but do know dairy products are typically high. However, there are varieties on the market that are lower in phosphorus. Cheese varieties with less than 100 mg of phosphorus per serving include:

Brie (1 oz)

Camembert (1 oz)

Cream cheese (2 Tbsp)

Feta (1 oz)

Fontina (1 oz)

Goat (soft, 1 oz)

Neufchatel (1 oz)

Sharp cheddar (2/3 oz)

Shredded parmesan (2 Tbsp)

Sodium

Cheese is also known to be high in sodium. But just as with phosphorus content, there are varieties that are lower in sodium. Brie, cream cheese, goat cheese (soft), natural sharp cheddar, natural Swiss cheese and ricotta are among the lowest in sodium (35 to 200 mg per ounce). In general limiting hard and processed cheeses will help keep sodium intake down. Some processed cheeses have over 400 mg sodium per ounce.

Potassium

Potassium in cheese is typically low. One exception is when potassium chloride is added to some of the low-sodium cheese options, such as low-sodium cheddar or Colby cheese. Check the ingredient label for this one.

So many options!

With so many varieties it can be very difficult to find the ones that not only taste good but align with your health goals. Check with your renal dietitian, they may be able to help you determine if cheese can be incorporated into your meal plan.

Abby Tibodeau, RD, LD

Abby has been a renal dietitian for over five years and continues to learn new things every day. She enjoys spending time outdoors with her husband and three children. Abby is currently working on her master's degree in dietetics.

Comments

MY HUSBAND IS SUFFERING FROM DIMINISHED KIDNEY FUNCTION DUE TO YEARS OF USE OF DRUGS FOR RHEUMATOID ARTHRITIS. NOW HE IS SUFFERING DUE TO CUTTING BACK ON ALOT OF THE MEDICINES AND WE ARE IN THE PROCESS OF TRYING TO ADOPT A DIET TO HELP HIS KIDNEYS. I AM VERY INTERESTED IN THE PHOSPHORUS PYAMID BY THE ITALIAN RESEARCHERS. I CANNOT SEEM TO FIND A BOOK TO TELL WHAT THE PROPORTIONS ARE AND THE FREQUENCY HE CAN EAT CERTAIN FOODS. ALSO COULD YOU RECOMMEND A BOOK FOR A DIET THE IS NOT TOOOOO COMPLICATED. THANKS LAUREL WILLIAMS

Hi Laurel,
I do not have additional information on the phosphorus pyramid unfortunately. You might try a Google search. You can also find many books and book reviews if you search Google for chronic kidney disease books. Perhaps another reader has a recommendation.

You know, of course, there are innumerable sites that list foods by their chemical content and their effects on the body. In our case, the kidneys.

My wife and I now have to deal with diet changes occasioned by my unexpected kidney failing,. My doctors are now attempting to identify what factor(s) is driving up BUN and Creatine levels.

At any rate, I don’t have to tell you, wives (or husbands, as the case may be,) can spend 24/7 on the Internet building their own kidney diet guidelines.

Kidney diet management, we’re quickly learning, is not just about one food component, like phosphorus. You might consider our plan to reach out to a Kidney Disease Nutritionist–perhaps at your local hospital. He or she can “evaluate” your husband and set down–detail–his dietary regimen, taking into account the foods that may also help or exacerbate any other of his health issues.

You will know he’s found a very good Nutritionist if that Nutritionist doesn’t just “suggest” eating and avoiding this and that food, but “orders” him to adhere to the kidney diet prescribed for him. And charges you with ensuring he sticks to it. You know, in the “tough-love” spirit.

I’ve no doubt you’re exhausted. As with my wife, the certified Nutritionist will have relieved you–his hard-working Caregiver-wife–of the burdens in his care . . . not the least of which (correct me if I’m wrong) is trying to figure out daily what to make for breakfast, lunch, dinner, or abbreviated dishes throughout the day.

If only the Dietary Road were a straight one for us. My heart goes out to your husband, and to you.

With dialysis patients there is a guideline to have dairy on a regular basis. Generally milk, yogurt, ice cream you would want to keep it to 1/2 cup per day. With cheese the serving size is generally one ounce. However, you may not want to have milk, ice cream and cheese all in the same day or it will increase the phosphorus level in your blood. The phosphorus binders do bind some phosphorus in your meal to help keep your body from absorbing it, but they only bind so much. It would still be recommended to monitor how much and how often you have cheese.

Some medications may also cause diarrhea, unfortunately. You may wish to speak with your doctor about the underlying cause of the diarrhea. It is not always what you are eating. You may try cutting out one food at a time to see if it is a food that would be causing you distress. Typically high fat foods can sometimes cause diarrhea, however, diets vary and one person may tolerate a food another person may not tolerate.

Palindromic arthritis is one of the lesser understood types of arthritis. You are right that it does not make senses that it moves from joint to joint. But then most types of arthritis do not make sense. It does not make sense that our immune system would attack our own bodies but in rheumatoid diseases it does.

Combining diets with different focus does get tricky. Ask for help from your healthcare team. Ask for a referral to a dietitian who can help with creating a plan that best meets your diet goals for kidney stone prevention and kidney diet.

It’s best if you have a discussion with your doctor and ask for a dietitian referral if you need to be on a restricted diet. One concern for people at your age is to avoid being over-restrictive as avoiding malnutrition is as important as eating in a kidney-friendly way. There are many articles, tools and resources on DaVita.com to help you learn more about kidney disease and diet.

Hi.
I was lucky enough to have a kidney transplant after 5 years of dialysis at this new year day. Thank the Lord.
Because of the change i am looking for a post transplant kidney dietitian. However,surprisingly the hospital did have any..
I live in san san Francisco. Would you advise me how to find one?

You might contact the transplant centers around the area to see if a dietitian is available. If not go to the Academy of Nutrition and Dietetics website, eatright.org, to search for a dietitian in private practice.